BILL NUMBER: AB 2394	CHAPTERED  09/28/00

	CHAPTER   802
	FILED WITH SECRETARY OF STATE   SEPTEMBER 28, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 28, 2000
	PASSED THE SENATE   AUGUST 31, 2000
	PASSED THE ASSEMBLY   AUGUST 31, 2000
	AMENDED IN SENATE   AUGUST 30, 2000
	AMENDED IN SENATE   AUGUST 25, 2000
	AMENDED IN SENATE   AUGUST 14, 2000
	AMENDED IN SENATE   AUGUST 7, 2000
	AMENDED IN SENATE   JUNE 15, 2000
	AMENDED IN ASSEMBLY   MAY 2, 2000
	AMENDED IN ASSEMBLY   APRIL 11, 2000

INTRODUCED BY   Assembly Member Firebaugh
   (Principal coauthor:  Senator Ortiz)

                        FEBRUARY 24, 2000

   An act to add Sections 852 and 853 to the Business and Professions
Code, relating to the healing arts.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2394, Firebaugh.  Healing arts:  cultural and linguistic
competency.
   Existing law includes provisions generally applying to the
licensure and certification of all healing arts practitioners.
   This bill would establish the Task Force on Culturally and
Linguistically Competent Physicians and Dentists, chaired by the
State Director of Health Services and the Director of Consumer
Affairs, and would specify the task force's duties, including, among
other things, developing recommendations for a continuing education
program that includes language proficiency standards of a foreign
language to meet linguistic competency, and identifying the key
cultural elements necessary to meet cultural competency, and
reporting to the Legislature and to licensing boards within 2 years
of its establishment.
   This bill would establish a subcommittee of the task force and
would require the subcommittee to submit a report to the task force
by March 1, 2001, to be forwarded to the Legislature with any
additional comments by April 1, 2001, on the feasibility of
establishing a pilot program that would allow Mexican and Caribbean
licensed physicians and dentists to practice in nonprofit community
health centers in California's medically underserved communities.
This bill would specify that the Medical Board of California and the
Dental Board of California shall pay the state administrative costs
associated with the task force and its subcommittee.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Thirty-three and eight-tenths percent of Medi-Cal recipients
in 1998 spoke a foreign language; Spanish was the number one foreign
language spoken.
   (b) National medical journals and associations have acknowledged
the importance of having medical providers be cultural and
linguistically competent to serve culturally diverse patients.
   (c) The Journal of the American Medical Association, 1999, "Race,
Gender, and Patient-Physician Relationship" Volume 282 #6, stated
that "Without cultural competence, a physician may (1)
unintentionally incorporate racial biases into his or her
interpretations of patients' symptoms, predications of patients'
behaviors, and medical decision making; (2) lack understanding of
patients' ethnic and cultural disease models and attributions of
symptoms; (3) be unaware of or have expectations of the visit that
differ from patients' expectations."
   (d) In 1995, 1,641 underrepresented minorities applied to
California medical schools and 231 were admitted; in 1998, this
number declined to 1,223 applications and 184 admissions.
   (e) Only 0.8 percent of medical schools in the United States
require a separate course on multicultural medicine; even fewer
require any classes in cultural and linguistic competency.
   (f) The lack of cultural and linguistic competency among medical
providers may be dangerous to the health of certain patients.
  SEC. 2.  Section 852 is added to the Business and Professions Code,
to read:
   852.  (a) The Task Force on Culturally and Linguistically
Competent Physicians and Dentists is hereby created and shall consist
of the following members:
   (1) The State Director of Health Services and the Director of
Consumer Affairs, who shall serve as cochairs of the task force.
   (2) The Executive Director of the Medical Board of California.
   (3) The Executive Director of the Dental Board of California.
   (4) One member appointed by the Senate Committee on Rules.
   (5) One member appointed by the Speaker of the Assembly.
   (b) Additional task force members shall be appointed by the
Director of Consumer Affairs, in consultation with the State Director
of Health Services, as follows:
   (1) Representatives of organizations that advocate on behalf of
California licensed physicians and dentists.
   (2) California licensed physicians and dentists that provide
health services to members of language and ethnic minority groups.
   (3) Representatives of organizations that advocate on behalf of,
or provide health services to, members of language and ethnic
minority groups.
   (4) Representatives of entities that offer continuing education
for physicians and dentists.
   (5) Representatives of California's medical and dental schools.
   (6) Individuals with experience in developing, implementing,
monitoring, and evaluating cultural and linguistic programs.
   (c) The duties of the task force shall include the following:
   (1) Developing recommendations for a continuing education program
that includes language proficiency standards of foreign language to
be acquired to meet linguistic competency.
   (2) Identifying the key cultural elements necessary to meet
cultural competency by physicians, dentists, and their offices.
   (3) Assessing the need for voluntary certification standards and
examinations for cultural and linguistic competency.
   (d) The task force shall hold hearings and convene meetings to
obtain input from persons belonging to language and ethnic minority
groups to determine their needs and preferences for having culturally
competent medical providers.  These hearings and meetings shall be
convened in communities that have large populations of language and
ethnic minority groups.
   (e) The task force shall report its findings to the Legislature
and appropriate licensing boards within two years after creation of
the task force.
   (f) The Medical Board of California and the Dental Board of
California shall pay the state administrative costs of implementing
this section.
   (g) Nothing in this section shall be construed to require
mandatory continuing education of physicians and dentists.
  SEC. 3.  Section 853 is added to the Business and Professions Code,
to read:
   853.  (a) A subcommittee of the task force established in Section
852 is hereby created to examine the feasibility of establishing a
pilot program that would allow Mexican and Caribbean licensed
physicians and dentists to practice in nonprofit community health
centers in California's medically underserved areas.
   (b) The subcommittee shall consist of the following members:
   (1) The State Director of Health Services, who shall serve as the
chair.
   (2) The Executive Director of the Medical Board of California.
   (3) The Executive Director of the Dental Board of California.
   (4) The Director of the Office of Statewide Health Planning and
Development.
   (c) Additional subcommittee members shall be appointed by the
State Director of Health Services, including the following:
   (1) Representatives of organizations that advocate on behalf of
California licensed physicians and dentists.
   (2) A representative of a nonprofit clinic association that
advocates on behalf of members of language and ethnic minority groups
and provides health services to a patient population that meets the
following characteristics:
   (A) Over 77 percent of patients are members of ethnic groups.
   (B) Over 92 percent of patients have incomes less than 200 percent
of the poverty level.
   (C) Over 62 percent of patients do not speak English as their
primary language.
   (d) The subcommittee shall report to the task force by March 1,
2001, and the task force shall forward the report, with any
additional comments, to the Legislature by April 1, 2001.
   (e) The Medical Board of California and the Dental Board of
California shall pay the state administrative costs of implementing
this section.
